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Thromb Haemost 2015; 114(04): 727-734
DOI: 10.1160/TH15-01-0037
Blood Cells, Inflammation and Infection
Schattauer GmbH

Neutrophil-to-lymphocyte ratio: an inflammation marker related to cardiovascular risk in children

Anna Prats-Puig
1   Girona Institute for Biomedical Research, Girona, Spain;
2   Department of Physical Therapy, EUSES University School, University of Girona, Girona, Spain
3   Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
,
Montserrat Gispert-Saüch
3   Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
,
Ferran Díaz-Roldán
1   Girona Institute for Biomedical Research, Girona, Spain;
3   Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
,
Gemma Carreras-Badosa
1   Girona Institute for Biomedical Research, Girona, Spain;
3   Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
,
Inés Osiniri
4   Pediatrics, Salut Empordà Foundation, Figueres, Spain
,
Montserrat Planella-Colomer
3   Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
,
Lluís Mayol
3   Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
,
Francis de Zegher
5   Department of Development & Regeneration, University of Leuven, Leuven, Belgium
,
Lourdes Ibánez
6   Pediatric Endocrinology, Sant Joan de Déu Children’s Hospital, Esplugues, Barcelona and CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), Barcelona, Spain
,
Judit Bassols
1   Girona Institute for Biomedical Research, Girona, Spain;
3   Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
,
Abel López-Bermejo
1   Girona Institute for Biomedical Research, Girona, Spain;
3   Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
7   TransLab Research Group, Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
› Author Affiliations Financial support: This study was supported by grant no. 10/00553 and 13/01257 (to A. L.-B.) from the National Institute of Health Carlos III (Fund FIS for Health Research, Spain) a project funded in part by FEDER (Fondo Europeo de Desarrollo Regional).
Further Information

Publication History

Received: 15 January 2015

Accepted after major revision: 08 May 2015

Publication Date:
29 November 2017 (online)

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Summary

Low-grade chronic inflammation plays a pathogenic role in cardiovascular disease. An increase in the ratio of circulating neutrophils to lymphocytes (N/L ratio) may serve as a marker of cardiovascular risk in adults. It was the study objective to study whether N/L ratio associates with vascular parameters in children. Subjects were 501 prepubertal and early pubertal Caucasian children (mean age 8.0 years; mean body mass index (BMI) Z-score 0.2 ± 0.9; 266 boys and 235 girls) recruited within an ongoing population-based study. The subjects were stratified into three groups according to age. Neutrophil, lymphocyte, BMI, waist circumference, systolic blood pressure (SBP) and carotid intima-media thickness (cIMT), assessed in all children. The N/L ratio, derived from the absolute neutrophil and lymphocyte counts. In children aged < 7 years (n=190, all prepubertal), no associations were observed between N/L ratio and either anthropometric or cardiovascular parameters. In children aged 7–9 years (n=171, 1.7 % early pubertal), higher N/L ratio associated with higher BMI Z-score and waist circumference (p=0.008 to p< 0.0001). In children aged > 9 years (n=140, 29.2 % early pubertal), N/L ratio associated again with BMI Z-score and waist circumference and also positively with SBP and cIMT (all p=0.008 to p< 0.0001). These associations remained significant in linear regression models following adjustment for possible confounding variables such as age, gender, fasting triglycerides, C-reactive protein and puberty (and for SBP and cIMT, adjustment also for BMI). In conclusion, our results provide the first evidence that a higher N/L ratio is associated with a less favourable cardiovascular profile in children and delineate the development of these associations from late childhood onwards.

Keywords

Body mass index - cardiovascular risk - children - intima-media thickness - neutrophils to lymphocytes ratio
 

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